June 2017 – Olanzapine has “broad spectrum” activity for difficult to treat nausea.
Olanzapine has broad activity at dopaminergic and serotonin receptors as well as activity along histaminic, muscarinic, and alpha-adrenergic pathways.
Nausea treatment includes eliminating nauseating medications or supplements when possible, assessing and treating constipation, and treating acid-related dyspepsia.
If an anti-emetic is needed, olanzapine is available generically as a tablet or ODT tablet inexpensively. Typical starting dose is
Olanzapine 2.5 mg twice daily for nausea.
We have used doses up to 5 mg every 6 hours with good effect, and usually only mild sedation.